NICE has issued draft updated quality standards on the diagnosis and management of lung cancer in adults.
A new addition is the recommendation that adults with lung cancer have investigations to complete diagnostic staging and assess lung function before starting treatment with curative intent. However, before finalising this statement, NICE is requesting feedback on whether there is currently variation in the extent to which the different investigations (PET-CT, spirometry and transfer factor for carbon monoxide [TLCO]) are used in local areas.
Adults with non-small cell lung cancer (NSCLC) stage IIIb, IIIc or IV who are having tissue samples taken, should have them taken in a form suitable for pathological diagnosis and assessment of predictive biomarkers, the updated standards state. NICE is requesting feedback on whether this statement should be focussed on adults with advanced NSCLC or on a wider population.
Another new addition is that adults with NSCLC stage I or II and good performance status have treatment with curative intent. However, NICE is asking for feedback on whether patients with stage IIIa NSCLC are always assessed for treatment with curative intent and if so, if it is routine practice.
The 2019 standards include recommendations for coordinated campaigns to raise awareness of the symptoms and signs of lung cancer and to encourage people to seek medical advice when needed. They also advise that adults with suspected or confirmed lung cancer have access to a named lung cancer clinical nurse specialist. New to the updated version is the recommendation that people with suspected or confirmed lung cancer who smoke are referred to an evidence-based stop smoking service.
Consultation is now open through the NICE website until 5pm on Friday 23 August 2019. The final standards are expected to be published in December.